| Project/Area Number |
17K09293
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
General internal medicine(including psychosomatic medicine)
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| Research Institution | The University of Tokyo |
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Principal Investigator |
Kojima Taro 東京大学, 医学部附属病院, 講師 (40401111)
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| Co-Investigator(Kenkyū-buntansha) |
秋下 雅弘 東京大学, 医学部附属病院, 教授 (00261975)
柴崎 孝二 東京大学, 医学部附属病院, 登録診療員 (20625735)
亀山 祐美 東京大学, 医学部附属病院, 助教 (60505882)
山田 容子 北里大学, 大学病院, 医員 (30701007)
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| Project Period (FY) |
2017-04-01 – 2020-03-31
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| Project Status |
Completed (Fiscal Year 2019)
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| Budget Amount *help |
¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000)
Fiscal Year 2019: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
Fiscal Year 2018: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Fiscal Year 2017: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
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| Keywords | 薬物有害事象 / 高齢者 / 減薬 / ポリファーマシー / 老年医学 / 薬物有害作用 |
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| Outline of Final Research Achievements |
We investigated the complexities of drugs prescribed for the older patients in specific diseases or clinical settings. First, we examined the prescription of 275 inpatients with dementia. Female and the greater use of drugs were significantly associated with decrease in number of drugs during admission. Next, we investigated anticoagulant prescribing and prognosis in older inpatients with atrial fibrillation. Median follow-up periods in patients with and without anticoagulants were 659 and 553 days. As a result, no correlation was observed between anticoagulant prescription and major bleeding. However, the rate of stroke was significantly higher conversely.Furthermore, the change of drug prescription in 1201 elderly people with dementia was examined, and it was found that there was an increase in potentially inappropriate medication in the elderly people with dementia.
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| Academic Significance and Societal Importance of the Research Achievements |
後期高齢者や認知症者においては、個々の疾患に有効性の高い治療法や既存のガイドラインに基づいた治療法が必ずし有効でないどころか、有害性が高い可能性が示唆されている。本研究においても高齢患者においてはpotentially inappropriateの処方が増加しがちであることや有効性の高いとされる薬剤の使用によって逆に有効性が低いことが明らかとなった。今後、認知症者を含む高齢患者の適正な薬物療法を定めていくにあたり、一助となる検討ができたと考えられる。
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